EyeWorld Weekly Update, September 22, 2017

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September 22, 2017
Volume 23 , Number 33

Study: Visual impairment found in all children born with congenital Zika syndrome

Visual impairment was found in all 32 infants who were part of a study that focused on ocular and neurological abnormalities in a cohort of children with congenital Zika syndrome. Led by Liana Ventura, MD, the cross-sectional study focused on infants born with microcephaly in Pernambuco, Brazil. In addition to confirmation of the Zika virus, a comprehensive ophthalmologic evaluation included visual acuity, visual function assessment, visual development milestone, neurologic examination, and neuroimaging. The mean age at examination was 5.7 months. All infants in the study had visual impairment, and 44% had retinal and/or optic nerve findings. All patients also had neurological and neuroimaging modalities. Cortical/cerebral visual impairment may be the most common cause of blindness in children with congenital Zika syndrome, the researchers concluded. The study appears in the Journal of the American Association for Pediatric Ophthalmology and Strabismus.

Dry eye and pain disorders more common in veterans with traumatic brain injury

Visual impairment was found in all 32 infants who were part of a study that focused on ocular and neurological abnormalities in a cohort of children with congenital Zika syndrome. Led by Liana Ventura, MD, the cross-sectional study focused on infants born with microcephaly in Pernambuco, Brazil. In addition to confirmation of the Zika virus, a comprehensive ophthalmologic evaluation included visual acuity, visual function assessment, visual development milestone, neurologic examination, and neuroimaging. The mean age at examination was 5.7 months. All infants in the study had visual impairment, and 44% had retinal and/or optic nerve findings. All patients also had neurological and neuroimaging modalities. Cortical/cerebral visual impairment may be the most common cause of blindness in children with congenital Zika syndrome, the researchers concluded. The study appears in the Journal of the American Association for Pediatric Ophthalmology and Strabismus.

Eyelid laxity not associated with obstructive sleep apnea, according to study

Dry eye and pain disorders occur more often in U.S. veterans with a diagnosis of traumatic brain injury, according to Charity Lee and co-researchers. Their retrospective cohort study focused on veterans seen at a Veterans Administration Hospital between 2010 and 2014. Researchers used a dendrogram to investigate the link between traumatic brain injury, dry eye, and other comorbid conditions. Of 3.26 million veterans seen during the time period, 3.97% had a diagnosis of traumatic brain injury. The latter group were more likely to have a dry eye diagnosis compared with counterparts without traumatic brain injury (37.2% versus 29.1%). There was a stronger link with traumatic brain injury and ocular pain compared with tear film dysfunction. Traumatic brain injury also had a stronger link to a diagnosis of chronic pain, headache, depression, or post-traumatic stress disorder. A cluster analysis found that traumatic brain injury, dry eye, and pain diagnoses of interest showed that central pain syndrome, cluster headache, sicca syndrome, keratoconjunctivitis sicca, and late effect of injury to the nervous system were clustered together. The research is published in the British Journal of Ophthalmology.

New clinical trials announced for AMD treatment

A cross-sectional study of 201 patients from a sleep clinic found no statistically significant association between obstructive sleep apnea (OSA) severity and eyelid laxity markers or secondary ocular surface disease (OSD). Led by Timothy Fox, MD, researchers included patients referred for overnight polysomnography during a 6-month period. Eyelid laxity and OSD were measured on bedside ophthalmic examination, and the presence of OSA was determined from polysomnography results. The mean patient age was 53.2 years. No association was observed between severity of OSA and an eyelid laxity score or an ocular surface score. In a subset analysis, male sex was associated with a higher ocular surface score, and older age and diabetes were associated with a higher eyelid laxity score. Only one patient had findings associated with floppy eyelid syndrome. Prior studies in this area may have been limited by confounding variables or the technique used to identify eyelid laxity, researchers concluded. The study appears in JAMA Ophthalmology.

RESEARCH BRIEFS

  • Use of a hydrogel sealant (ReSure, Ocular Therapeutix, Bedford, Massachusetts) did not appear to affect duration of surgery, 1-day IOP, corneal edema, or foreign body sensation, according to Nambi Nallasamy, MD, and co-researchers in their retrospective case study. Researchers used a 1:1 matched cohort of hydrogel sealant exposure-discordant eyes from cataract surgery patients. They focused on consecutive patients who had bilateral cataract surgery and in whom the sealant was used to secure clear corneal incisions in only one of two eyes. Ninety eyes (45 patients) were included. No wound leak was found in any eye; the sealant was out of place in 4.4% of eyes. There was no statistically significant difference between sealant and non-sealant eyes in total surgical time, IOP, corneal edema, or foreign body sensation at 1 day postoperatively. The study appears in the Journal of Cataract & Refractive Surgery .
  • Preoperative surgeon advice about the need for spectacles for distance correction is strongly correlated with spectacle use after routine cataract surgery, according to Daniel Farhoudi and coauthors. Researchers focused on 1,329 patients having bilateral cataract surgery. Five months after second-eye surgery, patients completed a five-item questionnaire about spectacle use. Of 387 patients advised by their surgeons to obtain distance spectacles after surgery, 77.3% did so. Of the 691 patients not advised to obtain glasses, 78.9% did not get glasses. Almost 50% of patients with spherical and cylindrical errors of more than 1 D did not get new distance glasses; about 25% of patients with bilateral emmetropia received new distance glasses. The study is published in Acta Ophthalmologica.
  • Ciliary muscle contraction for the restoration of accommodation was safe and improved short-term accommodative ability in patients with early emmetropic presbyopia in a prospective nonrandomized trial. Led by Luca Gualdi, MD, researchers studied 27 patients from 40 to 51 years old who were treated and 13 age- and refraction-matched individuals. All had emmetropia and needed near sphere add between +0.75 and +1.50 D. The protocol included four sessions of bilateral pulsed (2 seconds on/6 seconds off) microelectrostimulation with 26 mA for 8 minutes with a commercially available medical device. Uncorrected distance (UDVA) and near visual acuity (UNVA) and reading speed were measured before surgery and at 2 weeks postoperatively. The UDVA did not change, and no adverse events were noted. Both bilateral and monocular UNVA were stable in the control group. There were post-hoc significant differences for monocular and binocular UNVA after the second treatment and after the first treatment based on words per minute. About 67% of patients were very satisfied, and one patient (3.7%) was not satisfied. The average satisfaction score was 3 (satisfied). The study appears in the Journal of Refractive Surgery.
  • Women who give birth for the first time later in life had an independently associated higher risk of nuclear and cortical cataract, according to a study in postmenopausal women. Led by Sangshin Park, PhD, a study of 7,021 women in the Korea National Health and Nutrition Examination Survey divided participants in quartiles according to the age of first childbirth: 13 to 21, 22 to 23, 24 to 25, and 26 to 44 years. The prevalence of any age-related cataract was 64.9%. However, nuclear cataract prevalence was notably higher in postmenopausal women with a later age of first childbirth (24 to 25 and 26 to 44 years). Age at first childbirth increased the risk for nuclear and cortical cataract formation linearly 4% and 2%. The study is published in the journal Menopause.
PRODUCT NEWS
  • The i-Pen Tear Osmolarity System (I-MED Pharma, Montreal, Canada) has been registered for use in Japan. The i-Pen is a handheld device to measure tear osmolarity and diagnose and monitor dry eye disease.

This issue of EyeWorld Weekly Update was edited by Amy Goldenberg and Vanessa Caceres.

EyeWorld Weekly Update (ISSN 1089-0319), a digital publication of the American Society of Cataract and Refractive Surgery and the American Society of Ophthalmic Administrators, is published every Friday, distributed by email, and posted live on Friday.

Medical Editors: Eric Donnenfeld, MD, chief medical editor; Rosa Braga-Mele, MD, cataract editor; Clara Chan, MD, cornea editor; Reay Brown, MD, glaucoma editor; and Vance Thompson, MD, refractive editor.

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